tag:blogger.com,1999:blog-16638275.post115955320892568651..comments2024-01-05T19:30:12.040+00:00Comments on Dr Jest's Caseblog: TGIDoctor Jesthttp://www.blogger.com/profile/14446967855995345815noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-16638275.post-60942511257711688572009-11-18T11:24:11.372+00:002009-11-18T11:24:11.372+00:00Who knows where to download XRumer 5.0 Palladium? ...Who knows where to download XRumer 5.0 Palladium? <br />Help, please. All recommend this program to effectively advertise on the Internet, this is the best program!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-16638275.post-1159992131747324652006-10-04T21:02:00.000+01:002006-10-04T21:02:00.000+01:00Of course, oesophageal spasm gets better with GTN ...Of course, oesophageal spasm gets better with GTN too. [she adds mischievously]The Locumhttps://www.blogger.com/profile/01728391040852365113noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-1159868532196463202006-10-03T10:42:00.000+01:002006-10-03T10:42:00.000+01:00steve-- good points well made. But our local physi...steve-- good points well made. But our local physicians treat all chest pains with a cocktail of nitrites AND PPI straight off the bat, so resolving which eases the pain gets a little tricky after the fact. <BR/><BR/>sooz-- sadly no. Sid & Joelene are the original poster boy and girl for Big Tobacco. <BR/><BR/>shinga-- erudite as ever, and thanks very much for the pointers. as you rightly say our diagnostic arts ae still a little offbeam when they encounter the atypical. Sid may yet turn out to have some more significant pathology, but somehow I doubt it....Doctor Jesthttps://www.blogger.com/profile/14446967855995345815noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-1159601427630745702006-09-30T08:30:00.000+01:002006-09-30T08:30:00.000+01:00There's a reasonable chance that 'Sid's' negative ...There's a reasonable chance that 'Sid's' negative test results might otherwise have led to him being labelled with 'functional cardiac pain' rather than treated (albeit unhelpfully) with those drugs.<BR/><BR/>There is an interesting item in the New York Times about women who have negative test results and no sign of macrovascular disease but, on further testing, do show <A HREF="http://www.nytimes.com/2006/02/01/health/01heart.html?ei=5070&en=9dc702f736ff1df7&ex=1159761600&adxnnl=1&adxnnlx=1159600432-66x0/XxHjdh7g7MEMmcSRg" REL="nofollow">microvascular</A> disease. [If you're bugged for a log-in, go to <A HREF="http://www.bugmenot.com/" REL="nofollow">Bug Me Not</A> to bypass the registration.]<BR/><BR/>Ben Goldacre has an interesting discussion that <A HREF="http://www.badscience.net/?p=304#more-304" REL="nofollow">McKeith et al. harangue and intimidate their clients</A> in ways that would have a doctor struck off if they did that to their patients. <BR/><BR/>I thought that it was just people with COPD (aka give up smoking asap, it really is trashing your life) who refused to give up smoking. Usually on the grounds that, "You don't understand. I need to cough to clear my lungs and smoking helps me".<BR/><BR/>Medically Unexplained Symptoms has MUS. Is there also, MESTNA - Medically Explicable Symptoms To No Avail?<BR/><BR/>Regards - ShingaShingahttps://www.blogger.com/profile/18126212762767721751noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-1159575120709172162006-09-30T01:12:00.000+01:002006-09-30T01:12:00.000+01:00It must be sooooo frustrating when people are sick...It must be sooooo frustrating when people are sick and yet don't do the most obvious thing to help themselves.<BR/><BR/>Didn't it occur to him at any point that smoking might not help matters?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-16638275.post-1159555991094403522006-09-29T19:53:00.000+01:002006-09-29T19:53:00.000+01:00Now I'm a pharmacist, so not really trained in dia...Now I'm a pharmacist, so not really trained in diagnostics. However, even I know of a really easy way to distinguish between angina and acid reflux, and that's what GTN and Gaviscon do for the pain. If GTN eases it, then it's likely to be cardiac, and if Gaviscon eases it, its likely to be an upper GI cause. Given the A&E docs had all their wonderful tests, why didn't the possibility of a GI cause occur to them? I'd have thought that having wide patent coronary arteries make it pretty difficult to get angina.Anonymousnoreply@blogger.com